Why we need to talk more about anal cancer
Here’s a news story you won’t have spotted today – rates of anal cancer have risen by 300 per cent since the mid-70s.
The disease is now five times more common in women – and three times more common in men – than it was 40 years ago. And death rates have quadrupled over the same time period.
As with the majority of these ‘new stats’ stories, we sent out a press release to journalists at all the national news papers and broadcast outlets.
We thought an increase of this magnitude in any disease would warrant an explanation, or at least create some discussion. But the lack of any coverage suggests the national media is too squeamish to report on cancer of the anus. Why?
It wasn’t so long ago that ‘cancer’ was a term you were more likely to hear whispered in darkened corners rather than see splashed across newspaper headlines. It’s taken a long time to get cancer into everyday public conversation.
We now openly talk about the disease, and people inspire us with their personal experiences. You need only look at the phenomenon of #nomakeupselfies or the bravery of Stephen Sutton to see how times have changed.
But it would seem some cancer taboos still remain, and it’s no surprise to see these relate to our more intimate regions.
And when you consider the main risk factor for many of these cancers – a virus usually transmitted during sexual activity – you double the embarrassment factor.
Let’s start by putting things in perspective. Anal cancer may rarely be talked about – but that’s partly because it’s relatively rare, with around 1,200 people diagnosed each year.
And, until quite recently, statistics for the disease were grouped together with bowel cancer figures.
But we’ve now updated our statistics pages to include stand-alone figures for anal cancer, allowing us to see how things have changed over time.
What these latest figures reveal is a steady rise in the rates of people being diagnosed with this form of cancer.
Overall the rates have risen from 0.4 in every 100,000 during the mid 70s to 1.5 in every 100,000 today.
Interestingly, the rise has been far higher in women – increasing from 0.4 to 1.8 per 100,000 in women compared to 0.4 to 1.2 per 100,000 in men.
For an explanation of what’s behind this disparity, we need to start talking about sex.
Sharing is caring
In recent years we have seen a growing prevalence of infection with the human papillomavirus (HPV), a virus that is usually passed between people during sexual activity.
It’s extremely common, and there are a number of different types. Most people will be infected with it at some point during their lives and their body’s natural defences will fight it off without them ever knowing.
But, if the virus takes hold, it can lead to a chain of events that can result in cancer.
HPV infection has been linked to an increased risk of developing cancers of the cervix, penis, anus, vagina and mouth.
They are all parts of the body we might associate with sex, and mostly parts of the body we tend not to talk about.
Research looking at sexual attitudes and lifestyle suggests that, these days, more heterosexual couples are having anal sex, which might account for the higher rates of the disease in women.
But any sexual activity can increase the risk of passing on an HPV infection to a partner – male or female – so, even if you’ve never had anal sex, it’s no guarantee you won’t have been infected.
And it may even be possible to spread HPV to different parts of your own body once you’ve got the virus.
As with other sexually transmitted infections, using a condom can reduce the risk of passing on HPV but it isn’t guaranteed..
But nobody is suggesting you live a life of celibacy.
It’s the prevalence of the virus, rather than your sexual preferences, that mean you need to be aware of any signs or symptoms of HPV-related cancers.
The most common symptom of anal cancer is bleeding from your bottom. The cause is much more likely to be something less serious but it’s important to report it to your doctor and get it checked out.
Prevention is better than cure
So what can be done to tackle this rise in anal cancer rates?
In 2008 the UK introduced its HPV vaccination programme for girls, which immunises them against the two types of virus most closely linked to cancer.
As more women are vaccinated and grow up with this immunity, we should see a dramatic fall in the number of HPV-related cancers.
And a new vaccine is being tested that would protect against some of the other types of the virus as well.
That’s all very well for the ladies, but what about the gentlemen?
The Joint Committee on Vaccination and Immunisation (JCVI) is considering whether to extend the vaccination programme to boys, as rates of HPV-related cancers are also on the increase in men.
Given that women are already receiving the vaccine, heterosexual men will benefit from the ‘herd protection’ that happens when most women are vaccinated, so we need more evidence to show if it would be cost-effective to extend the existing programme to all boys.
The JCVI is kicking off a project to look at just that, so we should have more information soon.
Another option being studied by the JCVI is whether to just offer the vaccine to men who have sex with men.
But one of the best things we can do to help reduce the risk of anal cancer is to talk about it – including getting to know the signs and symptoms and how to go about reducing that risk.
Perhaps the media were too embarrassed to run our stats story; perhaps not. Embarrassment is perfectly understandable, but it’s vital it doesn’t become a barrier for anyone who might have symptoms or is worried about cancer.
If you have any questions about anal cancer, or any other type of cancer, you can call our nurses on 0808 800 4040.
Greg Jones is a press officer at Cancer Research UK
Read about the symptoms of anal cancer
Image credit: from Flickr